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Laparoscopy-assisted vs open total gastrectomy with D2 lymphadenectomy for advanced gastric cancer: results of a retrospective, multicenter study

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Abstract

The aim of this study was to retrospectively compare the results of laparoscopy-assisted total gastrectomy (LATG) with those of open total gastrectomy (OTG) for advanced gastric cancer. Patients undergoing total gastrectomy for a T4a, N0-3a-b, M0 gastric adenocarcinoma were divided into two groups. Patients in group A (n = 122) underwent LAG, whereas patients in group B (n = 109) underwent OTG. Mean length of follow-up was 39 months. Primary study’s endpoints were postoperative mortality and morbidity, overall late survival (OS) and disease-free survival (DFS). Secondary endpoints were the number of retrieved lymph nodes, operating time, intraoperative blood loss, postoperative length of stay (LOS) and the incidence of local recurrence. Twenty-four patients in group A (19.6%) required conversion into OTG. Postoperative mortality was absent in both groups. Postoperative morbidity was 19% in group A and 11% in group B [p = 0.19]. OS was 34% in group A and 42% in group B [p = 0.21]. DFS was 29% in group A and 33% in group B [p = 0.49]. Mean number of retrieved lymph nodes was 29 in group A and 34 in group B [p < 0.01]. Mean intraoperative blood loss was 230 ml in group A and 180 ml in group B [p = 0.02]. Mean postoperative LOS was 9 days in group A and 11 days in group B [p = 0.09]. Local recurrence was 19% in group A and 13% in group B [p = 0.20]. For advanced gastric cancer, OTG favorably compares with LATG.

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Funding

This study did not receive any particular funding or financial support.

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Authors and Affiliations

  1. Department of Surgical Sciences, University of Rome “La Sapienza”, Rome, Italy

    Giulio Illuminati, Saverio Cerasari, Priscilla Nardi, Rocco Pasqua, Salvatore Sorrenti, Daniele Pironi, Augusto Lauro & Vito D’Andrea

  2. Service de Chirurgie Digestive et Viscérale, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France

    Antonio D’Urso & Alfonso Lapergola

  3. “Pietro Valdoni” Department of Surgery, University of Rome “La Sapienza”, Rome, Italy

    Enrico Fiori

Authors
  1. Giulio Illuminati
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  2. Antonio D’Urso
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  3. Enrico Fiori
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  4. Saverio Cerasari
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  5. Priscilla Nardi
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  6. Alfonso Lapergola
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  7. Rocco Pasqua
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  8. Salvatore Sorrenti
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  9. Daniele Pironi
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  10. Augusto Lauro
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  11. Vito D’Andrea
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Contributions

GI: conceptualization, study design, data analysis, formal analysis, writing, and manuscript review. AD’U: study design, data analysis, formal analysis, and manuscript review. SC: data acquisition and data analysis. PN: data acquisition and data analysis. AL: data acquisition and data analysis. RP: data acquisition, data analysis, and statistical analysis. SS: conceptualization, data analysis, and manuscript review. DP: study concepts and manuscript review. AL: conceptualization, study concepts, and manuscript review. FC: data acquisition, data analysis, and manuscript review. EF: conceptualization, study design, formal analysis, and manuscript review. VD’A: conceptualization, study design, formal analysis, and manuscript review.

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Correspondence to Giulio Illuminati.

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Illuminati, G., D’Urso, A., Fiori, E. et al. Laparoscopy-assisted vs open total gastrectomy with D2 lymphadenectomy for advanced gastric cancer: results of a retrospective, multicenter study. Updates Surg 75, 1645–1651 (2023). https://doi.org/10.1007/s13304-023-01476-w

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